UKZN Academic Leads Mental Health Care Initiative
The Programme for Improving Mental Health Care in South Africa (PRIME - SA) is an initiative which promotes integrated mental health care for primary health care patients and provides evidence on scaling-up mental health services for development.
Led by Principal Investigator Professor Inge Petersen, who is based at the Discipline of Psychology on UKZN’s Howard College campus, PRIME-SA has as its goal the generation of world class research evidence on the implementation and scaling up of treatment programmes for priority mental disorders in primary and maternal health care contexts in low resource settings.
PRIME is a consortium of research institutions and Ministries of Health in five countries in Asia and Africa - Ethiopia, India, Nepal, South Africa and Uganda - with partners in the United Kingdom and the World Health Organization (WHO).
A six-year programme launched in May 2011, it is support by the British government’s Department for International Development (DFID).
More than 13% of the global burden of disease is due to mental illness. Although the vast majority of people affected by mental illness live in Low and Middle-Income Countries (LMIC), there is a large “treatment gap”, with up to four out of every five people with mental illness in LMIC going without mental health care.
PRIME aims to improve the coverage of treatment for priority mental disorders by implementing and evaluating the WHO’s mental health Gap Action Plan (mhGAP) guidelines in the five participating countries.
In South Africa, the mhGAP guidelines have been integrated into a set of chronic care guidelines called Primary Care 101 (PC101) that have been adopted by the Department of Health for Integrated Chronic Disease Management (ICDM).
PRIME-SA has also developed adjunct psychosocial counselling guidelines for people with depression and psychosocial rehabilitation (PSR) guidelines for people with severe mental disorders to be delivered by lay Psychosocial workers under the supervision of mental health specialists within a task sharing approach.
These guidelines are practical tools intended to empower health care practitioners to deliver mental health services at the primary health care level. By generating research evidence aimed at integrating mental health care into primary and maternal health systems, PRIME aims to make a direct contribution to reducing the “treatment gap” not only in the five PRIME countries but also in other low resource settings.
The objective is to provide evidence to the Ministries of Health to facilitate the scale up of the integration of mental health services. In the South African mental health care context, PRIME is developing scalable models and materials for integrating mental health into primary health care in alignment with the South African mental health policy framework (2013-2020) to close the treatment gap.
There are three specific phases:
- In the Inception phase which is complete, PRIME conducted a situational analysis of mental health services and needs in the target district and in collaboration with district level stakeholders developed and calculated the cost of an integrated mental health care plan comprising packages of mental health care for depression, alcohol misuse and psychotic disorders for delivery into chronic care at primary health care level embracing a task sharing approach.
- PRIME is currently located in the implementation phase which will evaluate the feasibility, acceptability and impact of the packages of care into the chronic care service delivery platform in four clinics. For psychosis, in addition to strengthening the psycho-educational component of the enhanced PC101 guidelines, psychosocial rehabilitation (PSR) guidelines have been developed for lay counsellors who will facilitate PSR groups. Counselling guidelines have also been developed for lay counsellors who will provide individual and group counselling for people with depression to address these gaps identified in the formative phase.
- In the Scaling Up phase the objective is to evaluate the scaling up of these packages of care in the district.
Earlier this year PRIME commissioned a photo essay featuring people with severe mental disorders who received the PRIME-SA psychosocial rehabilitation intervention package. The link is: